Does a history-indicated cerclage affect gestational age at delivery in women with evidence of recurrent cervical insufficiency?

Norman A. Ginsberg*, Emily Stinnett Miller, Susan E Gerber, Jeffrey S Dungan, Lee P Shulman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

OBJECTIVE: To determine whether women with recurrent evidence of cervical insufficiency (CI) and with a history-indicated cerclage (HIC) placed at the beginning of the second trimester will deliver later than the index case. STUDY DESIGN: Retrospective case-control study of singleton pregnancy with history-consistent CI. Patients had a cerclage placed between 12 and 16 weeks of gestation. Transvaginal cervical measurement was done between 18 and 24 weeks. Those with a cervical measurement ≤25 mm were considered to have recurrent CI (Group A). Gestational age at delivery of the index case (Group C) and the cerclage patients (Groups A and B), which are the same patients as Group C, was compared using Student’s t test. They have the same genetics and anatomy. RESULTS: A total of 124 women had an HIC. Sixteen (13%) had recurrent CI (Group A). Comparing cases, the proximate average age at delivery was 22 weeks as compared with 33 weeks and 3 days for those with a cerclage (p<0.001) (Group A vs. B). In those with a cervical length >25 mm (Group B), 96 (89%) had a term delivery. In the index cases 64% delivered at 22 weeks or less (Group C). CONCLUSION: Cerclage in those patients with recurrent CI has a significantly improved outcome as compared with the index case. This minimizes pregnancy loss.

Original languageEnglish (US)
Pages (from-to)389-391
Number of pages3
JournalJournal of Reproductive Medicine
Volume60
Issue number5
StatePublished - Oct 1 2015

Keywords

  • Cerclage of uterine cervix
  • Cervical cerclage
  • Cervical length measurement
  • Cervix
  • Cervix uteri
  • Coexistent conditions
  • Habitual abortion
  • Incompetent cervix
  • Miscarriage
  • Pregnancy complications
  • Prenatal ultrasonography
  • Preterm birth
  • Spontaneous abortion
  • Uterine cervix

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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